Thursday, July 31, 2014

We're in trouble. And I hope it is not too late.

When I was about eight years old, my father took me on a fishing trip to Montana. On the way, we stopped at Yellowstone National Park. This was absolutely fascinating to an eight year old boy who had never been anywhere so amazing.

On the way to Old Faithful, the traffic became backed up several times. My father called it a "bear stop." Yellowstone bears would stop traffic. People would take pictures. Some would feed the bears. 

My father, having grown up in that part of the country, was prepared for the bears. He opened a can of sardines. In front of me, right out the window, he fed sardines to hungry bears. Wow that was fun. It seemed so innocent at the time and the right thing to do.

Today, Yellowstone Park doesn't allow this. Bears had become so habituated to human handouts that they didn't forage on their own anymore. It was just too easy to get a handout from the humans every day. Yellowstone wasn't a petting zoo, it was a preserve and refuge for animals. Rangers worked hard to stop the behavior to protect the animals. That was actually the right thing to do.

Listen to me: I don't want to hear any whiny liberal crap about how you shouldn't judge or you don't know the story. I do know the story. My microcosm of the world is a glimmer of everywhere.

We're in trouble. And I hope it is not too late.

I'm talking about government entitlements, specifically Medicaid. When you give something to someone "for free" without any consequences or limits, they become dependent on it. I've seen it over and over. I have so many patients on Medicaid. Some have really low income. Some have average income. A few drive expensive cars and are on Medicaid. I have a doctor in an expensive neighborhood with two boys that get their Vyvanse at no charge to him. He's a doctor, but his kids' meds are free. I have other patients that are on government assistance... have been for years, and do nothing to get out of the hole. Nothing.

I don't have an abnormal cluster of Medicaid patients. This is the same all over. Just like the Yellowstone bears, people have lined up and have become habituated to the government paying for their medication. They get their medication at no charge or "nearly free." 

I'm really sorry if this offends you, but this is a very clear signal for trouble ahead. When the public becomes dependent on government assistance, they lose the drive and tenacity to pursue income on their own. Why would you work hard for something if it is just going to be given to you? 

I am not a heartless bastard. I understand that people run into financial problems. I've been there, believe me, I absolutely know what it is like to start over from scratch. No one wants grandma to suffer or go without her medication. No one wants children to suffer. BUT there has to be a limit!

Government entitlements: It's just like feeding bears in Yellowstone, it seems so innocent and feels like the right thing to do. But it isn't. To expect the government to take care of you... no, it's just not acceptable because it creates dependency. 

Wake up, people. Wake up.

Wednesday, July 30, 2014

A Pharmacist's tongue-in-cheek guide to patient etiquette

1. Be sure to stare at the pharmacist while your prescriptions are being filled. Staring at the pharmacist makes him or her work faster.

2. Never remember the name of the medications you want refilled. By calling it “the little white pill,” you are sure to receive the correct medication.

3. When calling in eight prescriptions or more, always arrive at the pharmacy to pick them up within 10 minutes. It is OK to hurry pharmacists; if they make a mistake, it won’t kill you or anything.

4. Feel free to ask the pharmacy staff for the exact price of your prescription before it is filled. The staff should know every co-pay for every insurance plan.

5. Always ask how long it will take to fill a prescription. If you’re lucky, you will get it for free if it’s not ready in 30 minutes or less. Also, be sure to keep asking if the prescription is ready every five minutes — pharmacists often keep prescriptions to themselves after they are filled just to tick you off.

6. Be sure to complain about the co-pay. The co-pay is set on the whim of the pharmacist and has nothing to do with the insurance company.

7. It is not necessary to present your insurance card—or even know the name of the company. Pharmacists are psychic and know everyone’s insurance.

8. Pharmacies encourage forgery. When you pick up a prescription for someone else, please forge his/her name.

9. Upon calling in a refill for a maintenance medication without refills, always question why the doctor has to be called when you've taken the same medication for years. It is only a myth that prescription medications have to be ordered by doctors.

10. Always question why the insurance company is so concerned about your getting Prilosec 10 days too soon. After all you’re paying $5.00 for it, and that’s all it costs.

11. Over-the-counter displays are put there in order to entertain children. Please encourage them to play with any item and even open one or two.

12. Make sure you save all your old insurance cards. One of pharmacists’ favorite games is to guess which one is current.

13. When you call in a prescription, just say, “Can I have my pills filled?” You can be sure the pharmacist will recognize your voice and know which medication you want.

14. Pharmacists are some of the few people whose ears work independently. So when you see a pharmacist on the phone, feel free to just start talking—his/her free ear will hear everything.

15. The pharmacist is the only person in the store who is really capable of writing down your refill numbers, so when you call, demand to speak to a pharmacist.

16. Try to do all your pharmacy business on a Monday. The pharmacist will appreciate it.

17. Another pharmacist favorite is to have a patient walk up and ask, “Can I pick up my prescription?” Guessing who you are is another pharmacist game.

18. When there are several people ahead of you near the pickup counter, always stand right at it. The pharmacist
will know how important you are and fill your Rx first, and, if not, you can listen to juicy patient-pharmacist conversations.

19. If you are not asked for your insurance card, it means that the pharmacist wants to fill your prescription and then, after you are told how much it is, you can shout, “I have insurance.” The pharmacist will be glad to do it over.

20. When you need a really old prescription filled, tell the pharmacist that you have a standing order for it. This works especially well if the doctor who wrote it is dead.

21. When you get a new insurance card, make sure you keep it a secret. The pharmacist would rather phone your old company to find out why your Rx is being rejected.

22. When you drop off a refill bottle, tell the pharmacist you’ll pick it up either today or tomorrow. This type of clarity helps him plan his workload.

23. When you order your prescriptions and the pharmacist asks which ones, respond by saying, “All of them.” He will know.

24. When asked for the number of your prescriptions, respond by saying, “I don’t know, you have it there.” The pharmacist will know.

25. When asking for a refill on a pain medication, make sure you wait until the last one is gone and then try to call late on Friday afternoon. It will be easy for the pharmacist to get in touch with the doctor for a new Rx.

From Drug Topics, see link here.

Monday, July 28, 2014

The Emasculation of Man is Complete

In the 1980s, a popular TV show was The Cosby Show...

Dr. Heathcliff Huxtable (Bill Cosby) -- The obstetrician/patriarch marked an evolution in what men were like on TV. Obviously accomplished professionally and a consummate family man, he could often look somewhat befuddled — he didn't have all the answers. His lawyer wife sometimes talked him through a situation. 

In the 1990s, a popular TV show was Home Improvement...

Tim Taylor (Tim Allen), Home Improvement -- "More power," he'd growl, trying to sustain a standard for manly men who love sports and tools and working with their hands — while trying not too hard to work with their minds. The show touched a zeitgeist-y little nerve amidst the first push back by some men to re-establish or re-define manhood.

In the end, however, I always looked at the show as Tim Taylor having to apologize to his wife in almost every episode.

Also in the 1990s and 2000s, a popular TV show was Everybody Loves Raymond...

Ray Barone (Ray Romano), Everybody Loves Raymond -- The sportswriter could act like he was 40 going on 14. In his role as family man, Ray seemed more interested only in steering clear of his relatives and their conflicts and peccadilloes. He'd only act like a loyal, loving partner to wife Debra when push came to shove — so his parents and brother, who lived across the street, ran amok. Boundaries, people! Father, in this case, didn't know best.

AND WHAT has been the result of this media brainwashing? What shows the proof that men are no longer men, in addition to lower sperm counts and metrosexuals?


That's right! Bronies PROVE completely that the emasculation of man is complete! But what are Bronies, you might ask? Oh, tsk tsk tsk, you will shake your head after hearing this one...

My Little Pony: Friendship Is Magic is an animated television series produced by Hasbro as part of its My Little Pony toy franchise, which is tied in with the 2010 launch of dolls and playsets, and original programming for U.S. cable channel Hub Network (formerly The Hub). The show received praise from television critics and parental groups. It also found an unlikely audience in a large group of Internet users in late 2010 and early 2011. These older fans, typically males from 18 to 35, were drawn to the show's characters, stories, animation style, and influence of the show's propagation as an Internet meme. The fandom adopted the name brony (plural bronies), a portmanteau of "bro" and "pony". Though initially considered to propagate the humorous and ironic concept of grown men enjoying a show for young girls, the fandom has shown deeper appreciation for the show far beyond this concept, and is considered part of a New Sincerity trend. Its technology-savvy members have created numerous works in writing, music, art, and video based on the show, have established websites and fan conventions for the show, and have participated in charitable events around the show and those that create it.

So this is the future of the male gender? Collecting and playing with little pink ponies? Men who sing the praises of "If you try to please everypony, you oftentimes end up pleasing nopony.” 

Give me a break.

Saturday, July 26, 2014

Some People Refuse to be Pleased

When I first started at my current Goofmart Pharmacy location, it took awhile to get to know the names of most of the patients. There's a few people that no matter how hard I try, I just can't remember their name, ever. Other people I had down right away. It's probably because I'm crazy. I don't know.

But there's one lady that started harrassing me about a month after my arrival. When I had to ask her name, she would belt out, "DON'T YOU KNOW MY NAME BY NOW?!" So then the next time she came in I remembered that she made me feel stupid, so I became stupid and couldn't remember her name again. So then she shamed me in front of all the technicians and other patients when she said, "I CAN'T BELIEVE YOU CAN'T REMEMBER MY NAME!"

That started some issue in my brain and now all I can remember is that her last name starts with W. So when I see her I just go to the letter W and look for her name. It's better than getting shamed again. It seems to work. But that's not Mrs. W's only issue. At one time we went through the automatic refill blues, ranging from "WHY DON'T YOU HAVE MY BLOOD PRESSURE PILLS FILLED?! I THOUGHT THEY WERE ON AUTOMATIC REFILL!" to "WHY DID YOU FILL MY BLOOD PRESSURE PILLS?! I'M SWIMMING IN THEM AT HOME!!"

The recent issue with Mrs. W is her husband's medications. She's not happy that she has to come by the pharmacy twice per month to get his medication. "WHY DO I HAVE TO COME DOWN HERE TWICE? WHY CAN'T I GET THESE MEDICATIONS AT THE SAME TIME?"

It took me a couple of months working with the automatic refill dates, realizing that there would be some surplus in supply at her home, but I was able to get the three medications filled on the same date. So when Mrs. W came in to the pharmacy the other day, I went to the letter W, found her husband's medications, explained that one would have a surplus because she picked it up not long ago, but that NOW she can pick them up all on the same date! Voila! I am the Master of the Pharmacists. Crown me with your appreciation!



I almost had that cone of shame off, but no, Mrs. W didn't realize that she had been paying for each medication separately and now since she was GETTING them all on the same day, she would be PAYING for all of them on the same day.

What's your "take home" pearl for today?


Friday, July 25, 2014

One minute to closing...

She came sliding in...


"I need my Norco!"

Thursday, July 24, 2014

We Don't Have It!

"Where is your [Product X]?" he asked.

"We don't carry that anymore."

"Yes you do! Where is it?"

"We used to carry it. After the remodel, some things were discontinued. We no longer carry that. Maybe you could try [Competitor 1] or [Competitor 2]?"

"You had it before! Are you sure you don't have it?!"

"No, we don't have it. I promise you I'm not lying about that."

"Well come out here and help me find it."

Now this is one of those situations where any normal pharmacist would just dismiss the guy, but at Goofmart Pharmacy, we live in fear of negative customer feedback and the consequent beatings that follow, so to humor the guy I step out of the box to "look" for something I already know we don't have.

"It used to be over here," the guy says.

"Yes, I know. It was right here," I say, pointing to where it used to be. "As I said, we no longer carry it."

"Why not?!"

"As I said, some slow selling items were discontinued after the remodel."

"Well why didn't you tell me that in the first place?"

Time to use the Stress Reduction Kit again:

Wednesday, July 23, 2014

Being Nice has a Price

Dude presents with an Rx for an Epi-Pen. He already knows it's going to be expensive on his insurance. Me, being the nice guy that I am... I tell him that there is a current offer ONLINE from Epi-Pen to take some money off the co-pay. 

I tell him, "Dude, you have to go ONLINE at HOME to sign up and get the info we need to split bill it. But don't just Google 'Epi-Pen discount' or you'll get some bogus discount thing that will just waste all our time." (I've been down that road too many times with people).

What does Dude do? He stands there at the drop off window on his smart phone trying to find the website. While he's looking, the tech and I fill his other two prescriptions. At least 15 minutes pass with him actively engaged on the cell phone trying to find the website. I love smart phones just as much as the next guy, but there's some things that are easier and faster on a regular computer. The tech brings up his medications to check out. We're going with what I told him-- GO HOME and find the coupon info at HOME and leave us ALONE. But no, Dude is going to stand there at the pick up window and clog our flow.

I pull up the computer. I type in "Epi-Pen discount Mylan" and there it is. First choice. Easy peasy. What's the problem? I tell Dude, "Ok, here it is. You need to go to There is a sign up form there you can fill out AT HOME and then come back LATER so we can process the info you get there."

What does Dude do? He slightly moves to the side to allow other patrons to get their medications. The next lady looks perturbed so the tech asks Dude to move out of the pick up area entirely. He reluctantly does so.

Dude continues on his cell phone for another 15 minutes and finally says, "I have the info." He then hands his bacteria-laden phone to the tech to put in the info. Despite all our efforts to get this Dude to go away and come back later, that was just out of the question.

What is the gem of wisdom for today? It's a two-fer!

1. Don't offer to help people!

2. These miserable manufacturer coupons are a REAL pain in the ass!

Tuesday, July 22, 2014

GI Elixir Number 1

At my Goofmart Pharmacy location we compound a special formulation for a lady named Hope. The doc calls it "GI Elixir Number 1." 

In order to compound GI Elixir Number 1, we need the following ingredients:

Lidocaine Viscous Solution

For some reason, the doctor decided to send a recent e-Script for each part separately, including the various ingredients of Donnatal. One of those ingredients is Atropine Sulfate. I don't know if the doctor was just drinking or hallucinating, but somehow he expected Hope to hope that she could measure out 0.0065ml of Atropine for each dose... in the way he wrote it.

What a nightmare. Doc, get a grip, ok?

This is exactly the kind of stuff that drives us pharmacists to the brink of insanity.

Monday, July 21, 2014

Magic Mike

Magic Mike is an immigrant.

He's here from another country, and for some reason our country gives people who immigrate here special treatment. Mike is on state-funded Medicaid and gets all his medications FREE (to him). And he's on a bunch of them, all taxpayer-funded. You, me, and our children all pay for this. That's ok. I'm sure that someone smarter than all of us have decided Magic Mike really needs us to pay for these medications. 

I don't know... someone might ask why WE have to pay for all these medications when Magic Mike constantly makes visits to his home country (on the other side of the globe, I might add) but somehow can't pay for his own medication. But not me! I don't ask those questions anymore because people think I'm picking on Medicaid patients. Oh it's a valid question, but not me, I won't ask it.

Magic Mike has an American girlfriend. She pays for her medications because she is not on Medicaid and has a job. Oh, did I mention that Magic Mike doesn't have a job? Why doesn't he get a job? Because he's not "well enough" (his words) to get a job. Oh, he's well enough to travel but not well enough to get a job. But who knows all the details there anyway.

One day Magic Mike had to come in and pay for his girlfriend's medications... and that's when he started in on ME. Oh he waxed eloquent on how he never had to pay for medication in his socialist country and how it's just awful that his sweet ailing girlfriend has to pay for her medication here in this heartless pharmacy. Oh, Mr. RxMan, can't YOU do something to help Magic Mike's girlfiend?

I told him there wasn't anything I could really do...

And then he cut me off and started ranting and raving on how we're taking advantage of his girlfriend (despite the fact that I told him her insurance sets the co-pay,. not us) and how we should be ashamed of ourselves and how this would never happen in his home country... blah blah blah.

I told him again... there's really nothing I could do about it. 

Magic Mike stared at me for about 30 seconds, pulled out a gold American Express card, paid for her meds, and left.